Marni Soupcoff: The seasonal flu shot and the public health damage done

The seasonal flu shot and the public health damage done

When Toronto Public Health states on its website that “everyone is at risk of getting the flu,” and urges us all to “get the flu shot each fall to protect you and your family, friends and co-workers,” its heart is surely in the right place. But it turns out the truth of the matter is a lot more complex. A new report based on an exhaustive three-year investigation has concluded that the seasonal flu vaccine is a great deal less effective than it’s been portrayed (it’s only 50%-60% effective in healthy people, rather than the common public health boast of 70%-90% effectiveness), and that vaccinating children does not seem to protect the vulnerable elderly population from flu, as is often claimed.

Ahead of each flu season, we are often told that the more accurate vaccine-makers’ predictions (or guesses) have been about which influenza strains will dominate that year, the more effective the vaccines will be. That doesn’t seem to be true either: The researchers found that even in 2009, when people in the United States were vaccinated with the exact same strain of flu that was causing a pandemic, the vaccine was only 56% effective. During the same pandemic in Canada, an unexpected effect was observed in which people who’d received a seasonal flu shot (which contained a strain that was different from the pandemic virus) actually seemed to be more likely to become infected with the pandemic virus than those who hadn’t been vaccinated at all — an outcome that was replicated in animal studies. Scientists are still trying to figure out why.

None of this is the end of the world. It’s not like we’ve discovered the seasonal flu vaccine poses any great danger to humankind, and it happens to be the best protection we’ve got against flu at the moment, which is better than no protection at all. But all the new information does lead one to wonder: Have our governments been wasting a huge amount of money on public health campaigns to achieve widespread vaccination, when the cash would be better spent on developing a more effective vaccine? The authors of the report certainly seem to think so, at least as far as the United States is concerned.

This is the impression one gets about Canada, too, where, according to an influenza expert quoted by the Canadian Press, we probably spend more than $100-million a year on seasonal flu vaccine programs — programs that, like the American ones, have rarely achieved more than 60% effectiveness in healthy people. (The vaccines are even less effective in old people and people in ill health.) But instead of working on taking a completely new vaccine direction, we’re working on convincing more people to use the inadequate one in which we’ve invested so much. It’s not a particularly sensible approach, though ending it would entail admitting a mistake, which is not government’s forte.

The biggest problem? By basing massive public health pushes for universal seasonal flu vaccination on beliefs that weren’t actually backed up by science — and supporting those pushes with exaggerated and inaccurate claims — Western governments have handed the paranoid anti-vaccine movement more ammunition for questioning vaccination in general. That’s dangerous because, while we can afford to have chunks of the population swear off a flu vaccine, we really can’t afford to have deadly scourges like measles and whooping cough make a comeback simply because patients don’t trust the public health establishment’s word.

It would have been better to have been more certain about flu vaccines before going whole hog on the PR offensive than to have sacrificed credibility on even higher-risk files.

Now participation in any future public health initiative will be a harder sell. Which really doesn’t protect you and your family, friends and co-workers very well at all.